Mesenteric Thrombosis as a Complication of COVID-19 Infection: A systematic review with meta-analysis

Abstract

he coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2), has spread over more than 200 countries worldwide. Although this disease affects mainly the respiratory system, other organs may be involved, usually due to coagulation disturbances that lead to a high rate of thrombotic complications. In this regard, deep vein thrombosis has been reported in up to 25–50% of COVID-19 patients requiring intensive care, with mortality rates being as high as 30–40%. Although less frequent, other thrombotic events such as intestinal, cerebral, and peripheral limb thrombosis have been reported, usually in critical patients. The prothrombotic effects of the virus may be directly related to its structure. It is known that the membrane of SARS-CoV-2 contains a Spike protein (protein S) which binds to the angiotensin-converting enzyme 2 (ACE2) receptor located on the membrane of host cells. ACE2 is most abundant in the lungs, intestine, oral mucosa, liver, and endothelium.